David Catron is riled up, responding to the recent Slate piece: “The authors of this disgraceful piece of agitprop would have their readers believe that the people who run hospitals deliberately allow people to languish in their ERs for financial gain. The suggestion is not merely slanderous. It is absurd on its face.
I have worked in hospital finance (at institutions large and small) for more than two decades and have never met an administrator or finance person (not one) to whom such an idea would even occur. Where I have worked, suggesting such a policy would get you fired.”
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Hospitals holding beds while patients wait in the ED. Absurd – Yes but its common in my neck of the woods. Hospitals do hold beds that are untouchable to the ED. They do it for their capitated patients that need to be transfered in after landing in other facilities. They do it for beds contracted to other facilities for specialized services. They dont talk about it and in my experience the official line is that they do not hold beds but they do. I can remember my experience working for a large academic medical center in California where I worked watching direct admit after direct admit role in while we had patients in the ED holding for up to two days. I gave some specific examples in comments about this over at emergiblog.
Well he is indeed a fortunate man. I worked for a clinic that got into a situation where it was largely capitated. We then ended up with a sociopathic administrator who actively opposed efforts to improve access to care, even expressing glee when telephone access was so bad that people couldn’t get appointments. When quality of care was raised, his reply was “Quality! Smality! If it isn’t on the spreadsheet, it doesn’t count!”
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